Toxicology

Question 1

[diagnose]

odorless, colorless gas

headache, confusion, decreased visual acuity, cherry red skin

Answer 1

CO

Tx: Hyperbaric Oxygen, 100% O2

Question 2

[diagnose]

colorless, irritating gas; forms sulfurous acid in contact with mucus membranse

conjuctival and bronchial irritation

Answer 2

Sulfur dioxide

Question 3

[diagnose]

brownish irritant gas

cause irritation of the ENT, lung, pulmonary edema

Answer 3

Nitrogen oxides

Question 4

[diagnose]

bluish irritant gas produced in water purification devices and electrical fields

irritation and dryness of mucosa, pulmonary function impaired at higher concentrations, chronic exposure leads to bronchitis, bronchiolitis, emphysema

Answer 4

Ozone

Question 5

[diagnose]

CNS depression, hepatotoxicity, nephrotoxicity

halogenated solvents

Answer 5

CCl4, Chloroform, trichloroethylene

Question 6

[diagnose]

CNS depression, ataxia, coma

aromatic hydrocarbons

Answer 6

Benzene
toluene
xylene

Question 7

[diagnose: pesticide]

tremors, seizures, infertility and breast, brain, balls cancer

chlorinated hydrocarbons

Answer 7

DDT and its analogs

Question 8

[diagnose: pesticide]

diarrhea, urination, miosis, bronchospasm, bradycardia, excitation, lacrimation, sweating, salivation

Answer 8

Carbamates, Organophosphates

Tx: Atropine + pralidoxime

Question 9

[diagnose: botanical insecticides]

initial excitation followed by paralysis of ganlionic, CNS and neurmuscular transmission

Answer 9

Nicotine

Question 10

[diagnose: botanical insecticides]

GI distress when ingested, conjunctivitis, dermatitis after direct contact

Answer 10

rotenone

Question 11

[diagnose: botanical insecticides]

causes contact dermatitis; large quantities cause seizures, and peripheral neurotoxicity

Answer 11

pyrethrum

Question 12

[diagnose: herbicides]

muscle hypotonia and coma, increases risk of NHL

includes Agent orange

Answer 12

Chlorophenoxy acids

1. 2,4-dichlorophenoxyacetic acid
2. 2,4,5, trichlorophenoxyacetic acid (agent orange)

Question 13

most widely used herbicide in the world

Answer 13

glycophosate

Question 14

[diagnose: herbicides]

initial effect is GI irritation with hematemesis and bloody stools; progressive pulmonary impairment

Answer 14

Glycophosate

Example: Paraquat

Question 15

[diagnose: environmental pollutants]

used in manufacturing electrical equipments

acne, erythema, folliculitis, hyperkeratosis; mild increase in liver enzyme

Answer 15

polychlorinated biphenyls

Question 16

[diagnose: environmental pollutants]

cystic acneiform lesions that form on the face and upper body, carcinogenic and teratogenic

Answer 16

Dioxins

Question 17

[diagnose: environmental pollutants]

cause fibrotic lung disorder, shortness of breath

associated with lung cancer, mesothelioma, cancers of the GIT

Answer 17

asbestos

Question 18

[diagnose: heavy metals]

acute abdominal colic, acute encephalopathy, acute encephalopathy

children who have ingested large quantities of chips or flakes of paint

Answer 18

lead poisoning

Question 19

[diagnose: heavy metals]

chronic exposure of this heavy metal, peripheral neuropathy (wrist drop), anorexia, anemia, tremor, weight loss, GI symptoms

in child: growth retardation, neurocognitive deficits, developmental delay

Answer 19

chronic lead poisoning (plumbism)

Tx: oral succimer in outpatients

EDTA +/- Dimercaprol

Question 20

[diagnose: heavy metals]

hallucinations, headache, irritability, convulsion, coma;

contained in antiknock gasoline additives

Answer 20

organic lead poisoning

Question 21

[diagnose: heavy metals]

released during coal burning;

severe GI discomfort, vomiting, rice-water stools, dehydration, shock

sweet garlicky odor in breath and stools

Answer 21

Acute arsenic poisoning

Tx: dimercaprol

Question 22

[diagnose: heavy metals]

released during coal burning;

hair loss, bone marrow depression and anemia, chronic nausea and Gi disturbances,

Transverse bands in nails

raindrop hyperpigmentation, milk and roses complexion, hyperkeratosis

Answer 22

chronic arsenic posoning

Question 23

[diagnose: heavy metals]

semiconductor company;

headache, dyspnea, weakness, vomiting, abdominal pain, massive hemolysis

Answer 23

Arsine gas

Tx: exchange transfusion, vigorous hydration, hemodialysis

Question 24

[diagnose: heavy metals]

dental laboratories, wood preservative, seed dressings, fungicides

Answer 24

mercury

Question 25

[diagnose: heavy metals] chest pain, SOB, N/V, renal damage, CNS damage, life threatening hemorrhagic gastroenteritis then renal failure

Answer 25

Acute inorganic mercury poisoning Tx: Oral Succimer + IV Dimercaprol

Question 26

[diagnose: heavy metals] loosening of gums and teeth, GI disturbances, erethism

Answer 26

Chronic inorganic mercury poisoning Tx: succimer + unithiol dimercaprol SHOULD NOT be used

Question 27

[diagnose: heavy metals] consumption of big fishes cerebral palsy, deafness, blindness, mental retardation

Answer 27

Organic Mercury Poisoning Minamata Disease

Question 28

[Guess the drug] Chelates arsenic and mercury co administered with EDTA in severe chronic lead poisoning

Answer 28

Dimercaprol

Question 29

[Guess the drug] chelates lead administered only when blood lead concentrations is greater than 45 mcg/dL

Answer 29

succimer

Question 30

[Guess the drug] chelator of arsenic and mercury used in acute severe arsenic poisoning, chronic severe mercury poisoning and lead poisoning

Answer 30

Unithiol

Question 31

[Guess the drug] chelator and DMARD, used for copper poisoning, wilsons disease, adjunct to gold, lead, arsenic intoxication can cause drug-induced lupus

Answer 31

Penicillamine

Question 32

[Guess the drug] chelates lead, cause ECG changes, hypocalcemia, nephrotoxicity

Answer 32

Edetate Calcium Disodium (EDTA)

Question 33

what will you give to prevent the dangerous hypocalcemia caused by EDTA?

Answer 33

calcium disodium salt

Question 34

[Guess the drug] drug chelator, acute iron chelator,used in iron overload states

Answer 34

deferoxamine

Question 35

[diagnose] delirium, hallucinations, seizures, coma, tachycardia, hypertension, hyperthermia, mydriasis, decreased bowel sounds, urinary retention

Answer 35

Antimuscarinic drugs

Question 36

[diagnose] anxiety, agitation, seizures, coma, bradycardia or tachycardia, pinpoint pupils, salivation, sweating, hyperactive bowel sounds, muscle fasciculation, paralysis

Answer 36

Cholinomimetic drug/organophosphate poisoning

Question 37

[diagnose] lethargy, sedation, coma, bradycardia, hypotension, hypoventilation, pinpoint pupils, cool skin, decreased bowel sounds, flaccid muscles

Answer 37

opioids Tx: naloxone

Question 38

[diagnose] ``` confusion hyperventilation acidosis fever seizures ```

Answer 38

salicylate toxicity

Question 39

[diagnose] disinhibition initially, then lethargy, stupor, coma nystagmus, decreased muscle tone, hypothermia, small pupils, hypotension, decreased bowel sounds in severe overdose

Answer 39

sedative hypnotics

Question 40

[diagnose] agitation, anxiety, seizures, hypertension, tachycardia, arrythmias, mydriasis, vertical and horizontal nystagmus with pcp skin is warm, sweaty, hyperthermia, increased muscle tone possible rhabdomyolysis

Answer 40

Stimulants

Question 41

[diagnose] type of antidepressant coma, convulsion, cardiotoxicity

Answer 41

tricyclic antiderpessants

Question 42

Drugs that can cause increased STOOL osmolar gap

Answer 42

``` Methanol Ethanol Diuretics Isopropyl alcohol Ethylene glycol ```

Question 43

Drugs that cause hyperkalemia

Answer 43

1. Beta-adrenergic blockers 2. Digitalis 3. Flouride 4. Lithium 5. K-sparing

Question 44

Drugs that cause hypokalemia

Answer 44

1. Beta adrenergic agonist 2. methylxanthines 3. Diuretics 4. toluene

Question 45

Activated charcoal is not effective for

Answer 45

1. Iron 2. Lithium 3. K 4. Alcohol 5. Cyanide 6. Acids 7. Solvents

Question 46

Activated charcoal is effective for

Answer 46

1. Amitriptyline 2. Barbiturate 3. Carbamazepine 4. Digitalis 5. Glycosides 6. Phencyclidine 7. Propoxyphene 8. THeophylline 9. Tricyclic antidepressants 10. Valproic acid

Question 47

Hemodialysis is not effective for

Answer 47

1. Amphetamines 2. Antidepressants 3. Antipsychotics 4. Benzodiazepines 5. CCBs 6. Digoxin 7. Metoprolol 8. Propanolol 9. Opioids

Question 48

Hemodialysis is effective for

Answer 48

1. Carbamazepine 2. Ethylene glycol 3. Lithium 4. Methanol 5. Metformin 6. Phenobarbital 7. Salicylate 8. Theophylline 9. Valproic acid